Successful Treatment of Anogenital Lichen Sclerosus With Topical Tacrolimus

TLDR

Anogenital lichen sclerosus is a chronic inflammatory and fibrosclerotic disease causing significant morbidity, for which topical ultrapotent corticosteroids are the current standard treatment. The study aims to confirm the efficacy of topical tacrolimus for anogenital lichen sclerosus through further clinical trials. The authors treated six patients—three prepubertal girls and three adults—with once‑daily 0.1% tacrolimus ointment. All patients achieved complete resolution with long‑lasting remission up to one year, experienced no major adverse effects, and the treatment was well tolerated, avoiding the skin atrophy seen with corticosteroids.

Abstract

<h3>Background</h3> Lichen sclerosus of the anogenital area is a chronic inflammatory and fibrosclerotic disease associated with substantial morbidity. Topical ultrapotent corticosteroids are currently the treatment of choice. <h3>Observations</h3> Three prepubertal girls and 3 adults (2 men, 1 woman) were treated with 0.1% tacrolimus ointment once daily. All patients experienced complete resolution with long-lasting remission for up to 1 year. No major adverse effects were observed, and treatment was well tolerated. <h3>Conclusions</h3> Topical tacrolimus is a promising novel agent in the treatment of lichen sclerosus of the anogenital area. A major advantage over topical corticosteroids is the lack of skin atrophy. Further clinical trials are warranted to confirm our findings.